Artificial Insemination 2 types,one of them being IUI.
• IUI – Intra-uterine insemination-
• It is a process of putting the washed sperms into the woman’s uterus, bypassing the cervix, around the time of ovulation
• IUI is commonly used for : –
1. Unexplained infertility – When the cause of infertility is not known despite all normal tests .
2. severe endometriosis
3. ovulation problem
4. cervical problems- hostile cervical mucus, torn cervix due to prior surgery
Male factor problems like :-
• Borderline sperm count
• low motility
• low sperm morphology
• Premature ejaculation
• Retrograde ejaculation (when semen is released into the urinary bladder)
• HIV Positive male – (sperm washing reduces the risk of transmission to the partner and future generation)
How is IUI done
• The medication to stimulate ovary to produce eggs can be given to a woman starting from D2 to D5 of her cycle. The aim is to get one or maximum 2 mature eggs for fertilization. This is a stimulated cycle where fertility drugs are given.
• In an unstimulated cycle, drugs are not given to stimulate the ovary. IUI is done around the time of natural ovulation.
• An ultrasound helps us to monitor the follicle development and helps us to know the mature size of the follicle and egg release. This allows insemination at the best time. • A women may ovulate naturally or HCG hormone infection can be given to induce ovulation.
IUI can be done 24-40 hrs after HCG injection or after 12-48 hrs of LH surge IUI should logically be performed around the time of ovulation. Since spermatozoa & eggs have a limited life. Therefore correct time of insemination is essential for success.
1. A semen sample is either given at home or preferably at clinic by masturbation after 2-3 days of abstinence .
2. The sample is then washed or processed in the laboratory.
* The sperm is separated from the other components of the semen and concentrated in a small volume.
* Various media and techniques are used for sperm washing and the selective is made depending upon the semen analysis report.
3. Sperm processing takes about 30-45minutes.
4. After preparation of semen, the speculum is inserted into the vagina to visualize the cervix.
5. Through a sterile flexible catheter the washed specimen of highly motile sperm are placed gently inside the uterus.
6. The egg – sperm fertilization then happens naturally inside the uterus.
REST AFTER IUI
10minutes of bed rest is sufficient after IUI.
• If donor’s frozen sample is used, it will be first Thawed & then processed.
16-20% if the women is less than 35yrs of age. Success rate decreases with increasing age .
COMPLICATIONS OF THE PROCEDURE
• Related to ovulation induction there is a small risk of developing ovarian hyperstimulation syndrome. it can occur when ovaries hyper respond to the fertility drugs . the size of the ovaries increases to several times its normal size and can leak fluid in abdomen, which can lead to weight gain , nausea, vomiting and bloating sensation.
A woman needs medical help in such a case and IUI should not be carried out. The risk of multiple pregnancies also increases due to fertility drugs.
• During the procedure, there may be a slight discomfort while inserting a catheter.
• At a maximum of 6cycles of IUI can be tried. If donor semen is used, 12cycles.